Leaving ArkansasBlueCross.com

By selecting "Continue," you will be exiting the Arkansas Blue Cross and Blue Shield (ABCBS) website. If
you choose to access other websites from this website, you agree, as a condition
of choosing any such link or access, that ABCBS is not and shall not be responsible
or liable to you or to others in any way for your decision to link to such other
websites. You further agree that ABCBS and its affiliates, its directors, officers,
employees and agents ("the ABCBS Parties") are not responsible for the content of
any other website to which you may link, nor are ABCBS or the ABCBS Parties liable
or responsible under any circumstances for the activities, omissions or conduct
of any owner or operator of any other website. Once you choose to link to another
website, you understand and agree that you have exited this website and are no
longer accessing or using any ABCBS Data. You understand and agree that by making
any third-party website link available as an option to you, ABCBS does not in any
way endorse any such website, nor state or imply that you should access such website
or any services, products or information which may be offered to you through
such other websites or by the owner or operator of such other websites. The owners
or operators of any other websites (not ABCBS) are solely responsible for the content
and operation of all such websites. ABCBS makes no warranties or representations
of any kind, express or implied, nor of merchantability or fitness for a particular
purpose, nor of non-infringement, with regard to the content or operation of any
other website to which you may link from this website.

Leaving ArkansasBlueCross.com

By selecting "Continue," you will be exiting the Arkansas Blue Cross and Blue Shield (ABCBS) website. If
you choose to access other websites from this website, you agree, as a condition
of choosing any such link or access, that ABCBS is not and shall not be responsible
or liable to you or to others in any way for your decision to link to such other
websites. You further agree that ABCBS and its affiliates, its directors, officers,
employees and agents ("the ABCBS Parties") are not responsible for the content of
any other website to which you may link, nor are ABCBS or the ABCBS Parties liable
or responsible under any circumstances for the activities, omissions or conduct
of any owner or operator of any other website. Once you choose to link to another
website, you understand and agree that you have exited this website and are no
longer accessing or using any ABCBS Data. You understand and agree that by making
any third-party website link available as an option to you, ABCBS does not in any
way endorse any such website, nor state or imply that you should access such website
or any services, products or information which may be offered to you through
such other websites or by the owner or operator of such other websites. The owners
or operators of any other websites (not ABCBS) are solely responsible for the content
and operation of all such websites. ABCBS makes no warranties or representations
of any kind, express or implied, nor of merchantability or fitness for a particular
purpose, nor of non-infringement, with regard to the content or operation of any
other website to which you may link from this website.

Employers

Group Administrator's Manual

Coordination of Benefits (COB)

COB Savings

Coordination of Benefits (COB) savings is the difference charged to the utilization
of the group based on Arkansas Blue Cross and Blue Shield's status as the primary
payer versus the secondary payer.

For example, if one of the employees had a $1,000 claim, and Arkansas Blue Cross
is the primary payer, we would pay 80 percent or $800 (assuming the coinsurance
is 80 percent, the deductible has been met and the charge is less than the maximum
allowance set by Arkansas Blue Cross).

Example 1

Arkansas Blue Cross as Primary Payer

Arkansas Blue Cross would pay 80 percent

• $1,000 x 80% = $800

If Arkansas Blue Cross is the primary payer, we will pay contract benefits (80 percent).
In the above example, $800 would be the 80 percent contract benefit.

Example 2

Arkansas Blue Cross as Secondary Payer

The other insurance company would pay 80 percent *

• $1,000 x 80% = $800

Arkansas Blue Cross pays the difference

• $1,000 - $800 = $200

Charge

$1,000

Our allowance

$800

Other paid

$ 800

We pay

$200

Balance

$ 200

* Other insurance companies may or may not pay 80 percent

Remember, the COB savings is the difference charged to the utilization of the group
based on Arkansas Blue Cross' payment status. Therefore, in Example 2, instead of
$800 being charged to the utilization of the group, only $200 is charged at a COB
savings of $600.

COB Letters

In order to determine Arkansas Blue Cross’ liability (primary or secondary payer);
our Coordination of Benefits (COB) Division will mail letters to your employees
asking for assistance. Because the requested information plays a role in determining
your group's utilization, it is important that these letters are completed and returned
as soon as possible.

If we have not received a response in 15 days, the claim(s) will be denied until
the requested information is received.

Listed below are some examples of the most common COB letters:

Our letter labeled C-00010 asks if dependents or the employee are covered
by any other insurance policy.

Once a year, our COB files are updated using the information provided in response
to our letter labeled C-00020; it asks if there have been any changes in
your employees' coverage by other insurance companies.

Our letter labeled C-00030 asks for clarification of custody in regard to
the insurance of your employees' children. (In case of divorce, the parent with
custody of the child is primary unless the court has declared otherwise.)

Please encourage your employees to respond as quickly as possible to the COB letters.
We are grateful for the opportunity to serve your employees, and it helps us serve
them with the right information available.